One who suffers from severe headaches due to caffeine withdrawal may take pills containing caffeine or headache relief pills while fasting * A dangerously ill person should consult a God-fearing doctor who can be relied upon, who is not overly apprehensive, nor dismisses the obligation to fast, whether he may fast * A pregnant woman is obligated to fast since it does not increase miscarriage risk, and if she senses danger to her life or her fetus during the fast, she should drink and eat as needed without limitation
Prohibition on Eating and Drinking
Anyone who eats or drinks even a minute amount on Yom Kippur transgresses a Torah prohibition, and if one ate an amount of a large date (“kotevet ha-gasa”) or drank a cheek full (“ke-m’lo logmav”) intentionally, he is liable for karet [spiritual excision]. If done accidentally (“be-shagaga”), he must bring a sin offering (“korban chatat”).
Therefore, even one who is suffering greatly – as long as fasting does not pose any mortal danger, he may not eat or drink even if he must remain in bed all day. He should try to pray as best he can, and make sure to recite vidui [confession] at least once.
One who needs to take pills for a few consecutive days, or feels significant discomfort unrelated to the fast, or has severe fast-induced discomfort – may swallow tasteless pills without water to heal him, or relieve his pain. If one cannot swallow the pill whole, he should chew and swallow it, or mix it with a tiny amount of soapy water to ruin the taste, and swallow the pill with that.
One who suffers from severe caffeine withdrawal headaches may take pills containing caffeine, or headache relief pills. Migraine sufferers may also take pills preemptively to prevent the onset of strong headaches.
It is permitted to take pills before the fast that alleviate the fast.
A Dangerously Ill Person
An ill person whose fasting may endanger his life, or weaken his coping with a dangerous illness, is obligated to eat and drink on the fast as needed. Even if it is clear the ill person has only a short time left to live, as long as fasting may hasten his death, he should eat and drink as necessary. One who is possibly in danger (“safek sakana”) and acts stringently not to eat or drink – sins.
An ill person should consult with a trustworthy, God-fearing doctor, who is not overly apprehensive, nor dismissive of the fasting obligation, whether he can fast. If he erred and did not consult with such a doctor before Yom Kippur, he has no choice but to eat and drink per his current doctor’s instruction.
An ill person who feels he is possibly in danger and needs to eat and drink on the fast – even if the doctors think his condition is not dangerous, should drink and eat. Similarly for a healthy person who becomes very weak on Yom Kippur, and feels he is about to lose consciousness. However, since sometimes the need is purely psychological, he should first taste a little, and only if he does not regain strength, continue eating and drinking in intervals, as explained next. And if he still feels uneasy, he should eat and drink until calm, and no longer in danger.
When to Eat in Intervals (“Le-shi’urin”)
Even though eating and drinking even a minute amount are biblically prohibited on Yom Kippur, when a dangerously ill patient does not need to urgently drink large quantities, several early halachic authorities (“Rishonim”) wrote it is preferable he drink and eat with interruptions of less than the amounts requiring karet, in order to minimize the transgression. Meaning, he should eat each time less than the volume of a large date (slightly over half an egg), and drink each time less than the amount of liquid that fills his cheek when full (ideally, this should be determined before the fast begins).
Ideally, he should eat and drink this small amount once every nine minutes, or if he needs more – once every seven minutes. For drinking, if more is needed, he can limit to a one minute interruption.
If there is concern that drinking and eating in intervals may lead to any negligence in strengthening the dangerously ill person, he should drink and eat normally. Therefore, when a woman postpartum (seventy-two hours from the moment of birth) is tired, it is best she drink normally, enabling continuous sleep without needing to stay awake to drink properly in intervals.
Diabetics whose condition is unstable must also be very careful about this, and if there is concern that eating in intervals may lead to negligence in not eating as needed – they should eat normally. And it is preferable they pray with a minyan in synagogue and eat a bit more frequently than the minimum portion, rather than being meticulous about eating le-shi’urim and not coming to synagogue. Children who are not fasting should eat and drink as usual.
A pregnant woman is obligated to fast on Yom Kippur, since fasting does not increase miscarriage risk. Only rarely it may hasten labor in the ninth month, which does not endanger lives. She is also prohibited from eating or drinking even in intervals.
However, if during the fast the pregnant woman senses her life or her fetus’ life is possibly endangered – she should drink and eat as necessary without limitation. In special high risk pregnancy cases, such as a woman who previously miscarried due to fasting, and in the first weeks of a pregnancy via fertility treatments, accordance to a God-fearing doctor’s instruction, she may drink, preferably in intervals.
A nursing woman is obligated to fast on Yom Kippur even if it is likely her milk supply will cease due to the fast, since it does not endanger life. However, when the baby is very weak, and the doctor thinks he especially needs his mother’s milk, and there is reasonable concern the fast will significantly diminish or cease her milk supply, in accordance with a God-fearing doctor’s instruction, she should drink in intervals.
From the time a woman goes into labor, or when she must urgently be rushed to the hospital, she is considered a dangerously ill person requiring normal eating and drinking. This is her status for 72 hours from delivery, and if they conclude in the middle of Yom Kippur, she may eat and drink as necessary until their conclusion. In the subsequent 96 hours (until the end of the seventh day after birth), if she and the doctor are certain she is not in danger, she should fast. Any time it is not certain, she should not fast, and if it is not difficult for her, it is preferable she drink in intervals.
Any bathing for pleasure is prohibited on Yom Kippur, even part of the body. This includes spraying perfume for a nice scent. However, bathing not for pleasure is permitted, such as spraying insect repellent on the skin, and washing dishes or utensils by hand to feed children. One who became very dirty or sweaty may wash that area of his body. If the dirt or sweat do not come off with water, liquid soap may be used.
One especially sensitive whose mind is unsettled without washing his face in the morning may do so. If he can be stringent in this matter, it is praiseworthy (“ta’vo alav bracha”). Anyone may wipe a slightly damp towel over his face, without enough moisture to wet his hand, to the point his hand could wet something else.
Even one suffering greatly may not rinse his mouth of its odor in the morning, lest he swallow a drop of water. But dry tooth brushing is permitted. If he still suffers greatly, he may brush with slightly soapy water.
Upon awakening or exiting the bathroom, one need only wash his fingertips and base of the fingers (where the fingers meet the palm), not the entire hand. This also applies to one who touched a covered bodily area with sweat beads before prayer. One who touches a covered bodily area or his shoes before Torah study, should do as usual – some wash both hands, some the hand that touched, some rub the hand on a garment. Kohanim wash the entire hand before Birkat Kohanim.
On Yom Kippur, one may not apply oil or anything else meant to nourish the skin, to even a small area of the body. Obviously, any makeup that may not be applied on Shabbat because of issues of dyeing (Tzove’a) or spreading (Memare’aḥ) may not be applied on Yom Kippur either, as everything prohibited on Shabbat is prohibited on Yom Kippur.
To relieve an itch, one may apply oil in liquid form to his skin (Yoma 77b), as long as he does not violate the prohibition of applying medicine; on Yom Kippur, as on Shabbat, it is rabbinically forbidden for one suffering from minor discomfort to use medicine, lest he grind herbal ingredients to prepare it. However, if healthy people occasionally use this oil, it is not considered medicinal, so one may use it to relieve itch. If the itch is painfully irritating, one may apply a factory-produced medicating oil
It is prohibited to walk on Yom Kippur with regular all-year shoes or sandals, even if not made of leather. One should rather wear simple indoor cloth or rubber slippers. However, one should not protest those who are lenient to wear non-leather shoes or sandals.
One walking where there is danger of snake or scorpion, or in mud, or a soldier on operational duty, may wear leather shoes. One may wear insoles to prevent pain.
From when children understand the Yom Kippur mitzvot (around age six), they are educated not to bathe for pleasure, apply ointment, or wear regular shoes. But before the age of education it is permitted for children to do these things for their own needs, while adults may not do them for the child’s pleasure. When necessary, not for pleasure, it is permitted to bathe and apply ointment to children. And when a child may be harmed without wearing shoes, he may wear them.
Many have the custom to encourage children who reached education age to abstain from eating and drinking at night. If the children also want to fast a bit during the day, they need not be prevented. But if they ask to eat and drink, they should be given food at night as well.
From age nine, healthy children are educated to fast at night, and a bit more during the day than usual. Weaker children are educated for this from age ten.
From age eleven, healthy children are educated to fast a full day. Weaker children may be lenient and fast until noon. From age twelve, girls are biblically obligated to fast, and boys rabbinically obligated. Only an ill boy may eat and drink, trying to fast until noon. From age thirteen, boys are also biblically obligated to fast.
This article appears in the ‘Besheva’ newspaper and was translated from Hebrew.